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Cold Sores

Aug 15, 2012 , Translated by Kristina Knazko

Cold sores are a common illness affecting a large amount of the population. The virus that causes cold sores is transmitted in childhood without any manifestations. The virus settles in the human body and is activated when the individual’s immune system is compromised.

Cold Sores

Cold sores are identified when the lip as well as the area around it is affected by the herpes virus. It is marked by painful blisters containing translucent and later purulent fluid. These blisters then burst to form small ulcers. They heal within 10 to 14 days, depending on how early treatment begins. Cold sores usually form on the lips, but can develop around the nose or eyes as well.

Cause of Cold Sores

The group of herpes viruses is quite vast and causes a number of different diseases. The most common of these viruses is the herpes simplex virus type 1 (HSV 1), which is the one than causes cold sores. Rarely is it found in different locations on the human body. HSV II is similar but it causes genital herpes, warts in the genital and anal area. These viruses are characterized by their ability to survive in the nerve nodules of the spine and head for the rest of an individual’s life.

Development of Cold Sores

A cold sore is an infectious disease affecting people of all ages regardless of race or gender. The infection enters the human body through broken skin or mucous membrane, usually in childhood. Transmission occurs mainly through direct contact with an infected ulcer or through bodily fluids. Due to more than 90% of the population being infected by the virus, infection usually occurs during the first year of life. Infections caused by herpes viruses have a characteristic course. First there is primary infection when the body is in contact with the virus for the first time. This usually occurs without symptoms. However, if this primary infection is coupled with the development of blisters, it is indicative of gingivostomatitis. Gingivostomatitis is an inflammation of the gums and other oral mucous glands where yellowish-white painful sores appear, resembling thrush. Fever accompanies the sores, and the illness disappears within two weeks. After primary infection, the virus travels along the nerve fibers to the nerve nodules along the spine or in the brain, where the virus lives for the rest of the individual’s life. The virus can travel from the nerve nodules at any time to the surface of the skin or mucous membrane. This occurs when the immune system is compromised by stress, fatigue, fever, sun exposure, menstruation, poor diet or due to another infection. When travelling along the nerve fibers, the virus often reaches the end and causes blisters. Sometimes blisters can even develop on the nerve fibers themselves.

Symptoms of Cold Sores

Cold sores are characterized not only by their development, but by the symptoms that precede it as well. After the incubation period (about 2 to 6 days) the affected area begins to feel tight and may itch or burn. When touched with the tongue, small hardened spots may be felt which can have small dots on their surfaces. Swelling and redness follows which precedes the blistering faze. The area of blistering is often formed by several tight blisters the side of pinheads. Later they burst and form scabs than fall off after some time. After 10 to 14 days the sores are healed. The affected area can be red for a while after the infection. In some cases the course of the illness is not as mild and other than painful blisters, serious complications can arise. These rare situations occur in immunosuppressed patients whose immune systems are supressed by medication. Patients with AIDS are also in danger of complications.

Complications of Cold Sores

Complications from cold sores develop in patients with impaired immune systems, such as cancer patients, transplant patients or patients with AIDS. Pneumonia, inflammation of the liver or inflammation of the eye can occur, leading to the development of corneal ulcers. Rarely can a patient develop herpetic meningoencephalitis, swelling of the brain and meninges. This is a very serious illness manifested by a fever, headaches, light sensitivity and neurological difficulties and often leads to coma and death.

Treatment of Cold Sores

The treatment of cold sores, or herpes simplex virus, is based on treatment of the affected area with products containing antiviral effects. These products, generally called antivirals, are administered mostly in cream or gel form. Treatment should be initiated as soon as possible, i.e. when the first symptom appears or with discomfort on the lip. Other options are antivirals in pill form, appropriate for people with reoccurring cold sores. These are mostly given to patients with a more complicated course of the illness, patients with impaired immune systems or as prevention for a possible outbreak. In general, with any suspicion of the development of a cold sore, antiviral treatment in the form of creams should be initialed as it comes into direct contacted with the affected are a immediately.

Risks of Cold Sores

Cold sores, which occur in healthy individuals, typically don’t have any long term effects and are not followed by complications. Sometimes a light scar can last on the lip for several weeks, but it eventually disappears on its own. Newborns and infants, who do not have a fully developed immune system, could be affected by the disease more seriously. This is why it is important to limit contact with individuals suffering from cold sores. Adults with a weakened immune system should also limit contact with individuals with cold sores. Therefore risk factors are primarily close contact with the ill. Risk factors for cold sores also include stress, high fever, menstruation, sun exposure or other infectious illnesses.

Prevention of Cold Sores

Prevention of cold sores is mostly focused on avoiding contact with the ill. This also applies to the use of common towels, utensils, creams or lip balms. Preventions also includes avoiding direct sun exposure, strengthening the immune system, balanced lifestyle, plenty of fluids, regular and enough sleep as well as enough physical activity.

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